Document Detail


Manual wheelchair propulsion patterns on natural surfaces during start-up propulsion.
MedLine Citation:
PMID:  19887217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To classify propulsion patterns over surfaces encountered in the natural environment during start-up and compare selected biomechanical variables between pattern types. DESIGN: Case series. SETTING: National Veterans Wheelchair Games, Minneapolis, MN, 2005. PARTICIPANTS: Manual wheelchair users (N=29). INTERVENTION: Subjects pushed their wheelchairs from a resting position over high-pile carpet, over linoleum, and up a ramp with a 5 degrees incline while propulsion kinematics and kinetics were recorded with a motion capture system and an instrumented wheel. MAIN OUTCOME MEASURES: Three raters classified the first 3 strokes as 1 of 4 types on each surface: arc, semicircular (SC), single looping over propulsion (SL), and double looping over propulsion (DL). The Fisher exact test was used to assess pattern changes between strokes and surface type. A multiple analysis of variance test was used to compare peak and average resultant force and moment about the hub, average wheel velocity, stroke frequency, contact angle, and distance traveled between stroke patterns. RESULTS: SL was the most common pattern used during start-up propulsion (44.9%), followed by arc (35.9%), DL (14.1%), and SC (5.1%). Subjects who dropped their hands below the rim during recovery achieved faster velocities and covered greater distances (.016< or =P< or =.075) during start-up on linoleum and carpet and applied more force during start-up on the ramp compared with those who used an arc pattern (P=.066). CONCLUSIONS: Classifying propulsion patterns is a difficult task that should use multiple raters. In addition, propulsion patterns change during start-up, with an arc pattern most prevalent initially. The biomechanical findings in this study agree with current clinical guidelines that recommend training users to drop the hand below the pushrim during recovery.
Authors:
Alicia M Koontz; Bailey M Roche; Jennifer L Collinger; Rory A Cooper; Michael L Boninger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  90     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-05     Completed Date:  2009-12-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1916-23     Citation Subset:  AIM; IM    
Affiliation:
Human Engineering Research Laboratories (151R1-H), VA Pittsburgh Health Care System, 7180 Highland Dr., 151R1-H, Pittsburgh, PA 15206, USA. akoontz@pitt.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Arm / physiopathology*
Biomechanics
Equipment Design
Female
Floors and Floorcoverings*
Humans
Kinetics
Locomotion / physiology*
Male
Spinal Cord Injuries / physiopathology*
Surface Properties
Task Performance and Analysis
Veterans
Wheelchairs*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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